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HIV/AIDS menaces progress in Ukraine

Iodine Deficiency also undermining young people’s health

KIEV/NEW YORK/GENEVA. 11 May 2004 – Ukraine is on the threshold of a full-scale HIV/AIDS epidemic, with an estimated quarter of a million people living with HIV/AIDS, UNICEF said today, as its Executive Director Carol Bellamy arrived in the country on an official visit. In addition a large proportion of its population faces a range of iodine deficiency disorders (IDD).

“Ukraine has one of the fastest-growing HIV infection rates in Eastern Europe, but most troubling is the rate of increase, which is having a disproportionate impact on children and young people,” Bellamy said.

In Ukraine, the spread of HIV is being driven by injecting drug use and to a lesser but growing extent, unsafe sex among young people. Parent- to- child transmission of HIV shot up from 2 per cent of total infections in 1997 to 13 per cent in 2001, and while 57 per cent of infections are among males, young females are increasingly becoming infected.

“National and local leaders, with full support from the international community, must take immediate, concrete action to address the extreme vulnerability of young people to HIV infection,” Bellamy said.

Ukraine’s AIDS crisis part of a bigger, regional picture.

Eastern Europe as a whole experienced a shocking 1,300 per cent increase in prevalence of HIV infection between 1996 and 2001 - occurring within a context of social unrest, widening inequality and a major expansion of drug trafficking networks.

“Far too many young people face poverty, high unemployment, and lack of hope - the lifeblood of the drug trade, which in turn feeds the HIV epidemic,” Bellamy said.

More than 80 percent of people living with HIV/AIDS in the region are under 30 years old, unlike Western Europe and the United States, where only 30 per cent of HIV cases are among people under 30.

Access to the limited services available is particularly difficult for young people, and especially for groups such as intravenous drug users and commercial sex workers. Members of at-risk groups are often subject to social exclusion, stigmatisation or incarceration – factors that fuel the spread of HIV. Less than 5 per cent of injecting drug users have access to programmes or services to reduce their risk of HIV infection.

“We are faced with an obscene situation where those who are the most vulnerable are also the least likely to have the support they need to prevent HIV infection,” Bellamy said. One UNICEF poll found that less than 70 per cent of Ukrainian teenagers were aware of condoms as a means of prevention; awareness of other practices, such as sexual abstinence, having fewer sexual partners and not injecting drugs, is also low.

Iodine deficient diet

While Ukraine produces and exports iodized salt, only 20 percent of households consume enough iodized salt to prevent IDD. A 2002 assessment confirmed the presence of mild iodine deficiency throughout the country, and severe IDD in the north and west. This translates into impair mental capacities among children, with enormous implications for the country’s ability to grow and prosper.

“Iodine deficiency disorders can be eliminated,” said Bellamy. “One teaspoon of iodine over a lifetime is sufficient to protect a person from IDD. Iodized salt is universally recognized as the most efficient, safe and cost-effective way to reach populations at large,” she said. The challenge for Ukraine is to enact legislation to ensure that all salt produced in the country is iodized.

Iodine deficiency has contributed to the devastating effects of the 1986 Chernobyl nuclear disaster. Low iodine status has left Ukrainians more susceptible to the radioactive iodine that was released during the explosion, which has led to an upsurge in thyroid cancers.

***UNICEF action

Ukraine’s response to the HIV/AIDS epidemic and to IDD will hinge on leadership from all sectors of society.

UNICEF works with the Government of Ukraine in the prevention of parent-to-child transmission of HIV, which is now included in state programmes on AIDS prevention. Coverage of HIV-positive pregnant women with prevention and treatment services increased from only 9 per cent in 1999 to 91 per cent in 2002.

UNICEF advocates for, and provides technical support to ensure that children and young people are informed about HIV/AIDS and have the life-skills to avoid risk-taking behaviour. Scaling-up prevention services for high-risk groups including intravenous drug-users as well as for the general youth population, are urgent priorities.

UNICEF supports the national campaign to achieve universal salt iodization by 2005, through advocacy, mass media and communications. UNICEF seeks to garner political support for the campaign, create informed demand for iodized salt, and persuade producers and manufacturers of the market benefits of salt iodization.

For nearly 60 years UNICEF has been the world’s leader for children, working on the ground in 158 countries to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for poor countries, UNICEF supports child health and nutrition, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.